Functional impairment among adults with neurolathyrism-related spastic paraparesis in Amhara National Regional State, Ethiopia

Neurolathyrism causes lifelong, incurable spastic paralysis of the lower limbs and permanent disability. Evidence on its impact on daily functioning and quality of life is limited. This study assessed functional impairment among people with neurolathyrism in grass pea-growing districts of Amhara, Ethiopia. A community-based cross-sectional quantitative study was conducted among 346 individuals diagnosed with neurolathyrism from grass pea-producing districts of the Amhara National Regional State. Functional impairment was assessed using the 12-item, interviewer-administered WHO Disability Assessment Schedule. Thirty-five trained BSc nurses collected data using tablets with Kobo Collect v2024.1.3. Data were analyzed using STATA 17, applying descriptive statistics and ordinary logistic regression. More than half of the participants reported severe functional impairment. Mobility was most affected (79.2%), with nearly nine in 10 experiencing difficulties. Participants aged 45-54 years had over twice the odds of functional disability compared with those aged 18-25 years [adjusted odds ratio (AOR) = 2.3, 95% confidence interval (CI): 1.0-5.3]. Men were more likely to experience functional disability than women (AOR = 1.9, 95% CI: 1.2-2.9). Living with neurolathyrism for 21-25 years was also significantly associated with higher odds of functional disability. Being married was protective compared with being unmarried (AOR = 0.5, 95% CI: 0.3-0.9), and those who sought spiritual treatment were 63% less likely to report functional disability (AOR = 0.4, 95% CI: 0.2-0.6). These findings show that neurolathyrism places a significant long-term burden on adults, particularly affecting mobility and self-care, highlighting the need for targeted rehabilitation and sustained support.